How much rates vary
Facilitymedian $1,950 · 10th to 90th $166 to $4,467Professionalmedian $162 · 10th to 90th $110 to $933
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $162.18 Median $1,445.44 Typical High $6,760.83 | Facility | None | $162.18 | $1,445.44 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $147.91 Typical High $151.36 | Professional | None | $102.33 | $147.91 | $151.36 |
Ambetter Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | None | $114.82 | $114.82 | $114.82 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $660.69 Median $2,818.38 Typical High $4,570.88 | Facility | None | $660.69 | $2,818.38 | $4,570.88 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $114.82 Median $162.18 Typical High $223.87 | Professional | None | $114.82 | $162.18 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $436.52 Typical High $575.44 | Facility | None | $371.54 | $436.52 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $173.78 Typical High $204.17 | Professional | None | $141.25 | $173.78 | $204.17 |
Medica Setting Facility Modifier None Typical Low $151.36 Median $245.47 Typical High $2,630.27 | Facility | None | $151.36 | $245.47 | $2,630.27 |
Medica Setting Professional Modifier None Typical Low $151.36 Median $933.25 Typical High $1,258.93 | Professional | None | $151.36 | $933.25 | $1,258.93 |
United Setting Facility Modifier None Typical Low $269.15 Median $1,148.15 Typical High $2,454.71 | Facility | None | $269.15 | $1,148.15 | $2,454.71 |
United Setting Professional Modifier None Typical Low $100.00 Median $141.25 Typical High $208.93 | Professional | None | $100.00 | $141.25 | $208.93 |
5 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $51.29 Median $53.70 Typical High $75.86 | Professional | 52 · Reduced service | $51.29 | $53.70 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $21.38 Typical High $30.20 | Professional | 53 · Discontinued | $20.42 | $21.38 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $79.43 Typical High $112.20 | Professional | 54 · Surgery only | $75.86 | $79.43 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $15.85 Typical High $22.91 | Professional | 55 · Aftercare only | $15.14 | $15.85 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $10.72 Typical High $15.14 | Professional | 56 · Pre-op care only | $10.23 | $10.72 | $15.14 |
Where Oklahoma sits
The same service costs 6.3 times more in New York than in Montana. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Physician feeFacility fee
NY $2,712MT $427
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.